Communication with Medical Consultants

Discussion of an individual patient with the other medical consultants involved in that person's care is an important part of your job as a medical professional. In the hospital setting, much of this communication is carried on in the patient's record, but frequently this is not enough. There are nuances of concerns and information that are difficult to convey through the written word. Sometimes, we just want to better understand what the other physicians are thinking but may not necessarily be writing in the chart, like what are the other possible diagnoses or what other treatment options might be available in a particular situation. In that case, we really should make the extra effort to call the consultant and discuss the situation directly.

Additionally, there may be some communication with consultants that is more urgent than just entering something in the record and waiting till the physician comes along on rounds to read the chart. Don't let communication hassles prevent you from making the call.

What communication hassles?

We've all run into these snags that interfere with our ability to talk directly to one another. These include things like paging a doctor and waiting for a call back, cell phones not working well inside hospitals or offices, trying to find out who is on call for a certain group of physicians, having to wait to get through answering services, not wanting to "bother" another busy physician, etc., etc. Even though communication technology has improved tremendously in recent years and even though we may have the technological capability to make it better, there continue to be stumbling blocks in this process which hopefully can be ironed out in the future.

Nevertheless, good patient care is more important than these minor interferences, and we need to be sure to make the effort to communicate well so that the plan of care can be well-coordinated and everyone knows who needs to know what's going on with the patient.

Patients expect us to communicate with each other and are dismayed when we do not. Many of them have had experiences where doctors duplicate testing procedures that have already been done recently, or one doctor initiates a medication that may be in conflict with another medication prescribed by a different medical consultant. The patients may be astute enough to recognize what's happened, but they may not or they may be so trusting as to assume that the doctors "know what they're doing".

This is frequently a matter of patient safety and requires that we as health care professionals take steps to protect our patients from harm. If you and the patient don't know what other medicines the patient is taking, or if you don't know what all the diagnoses and plans are for your patient, you need to find out before you prescribe something that is potentially dangerous. Get records. Make a phone call.